1. Field of the Invention
The present invention relates to a surgical stitching device and to its use in closing laparoscopic incisions to prevent the development of hernias. The device may also be used for ligating an artery, ligament and so forth where suturing is otherwise difficult.
2. Brief Description of the Prior Art
Larger cannulas are needed to accommodate larger instruments in laparoscopy and to remove tissue specimens. The introduction of cannulas 10 mm or larger in diameter has led to an increased risk of incisional hernias. As reported by Kadar N., Reich H., Liu C. Y., Manko G. F. and Gimpelson R. J. in an article entitled "Incisional hernias following major laparoscopic gynecological procedures", the incidence of incisional hernia is greatly increased when a 10 mm or larger trocar is used at an extra-umbilical site. Under those circumstances, the authors believe that the underlying fascia should be closed and that even the peritoneum may require closure at a 12 mm trocar site.
Presently, large laparoscopic incisions are closed with curved or straight needles. Curved needles are often difficult to place with standard needle holders operating outside the abdomen. Whereas straight needles are inserted through fascia and peritoneum from outside to inside and then with laparoscopic graspers are manipulated from inside to outside again with much difficulty.
The surgical stitching device of the present invention allows a surgeon to place a "through and through" suture incorporating the fascia and peritoneum on each side of a laparoscopic incision with much less effort than is needed with present needles. The incision is then closed with an external knot.